Methamphetamine Use Is Heightening Risks Among Gay Youth

A convincing body of new research suggests that a relatively recent and very important risk factor for HIV among men who have sex with men (MSM) is methamphetamine use. Illegal stimulants have become such a commonplace part of the party circuit and gay club life that some treatment centers have seen a 1,000 percent increase in people presenting for treatment of methamphetamine abuse.

While HIV clinicians have long known the connection between substance abuse and HIV, especially when injectables are used, investigators are building a strong case for paying particular attention to methamphetamine and other stimulants used by MSM. Even when these drugs are not injected, they place users at a high risk of HIV infection, according to several presentations at the July 2002 14th International AIDS Conference in Barcelona.

"With methamphetamine ... people become uninhibited on the drug, and then it becomes an issue of sexual transmission," said E. Michael Gorman, Ph.D., M.P.H., M.S.W., a chief investigator of numerous methamphetamine and HIV studies. "They forget; they don't put on a condom right or don't use a condom if they think to bring one," he said.

"What we see is that these drugs cause people to take more risks, cause more partnering, cause more people to have sex, create an insatiable sexual desire, and cause people to do more extreme sex than regular sex," said Perry N. Halkitis, Ph.D., assistant professor of psychology at New York University. "And if methamphetamine is inserted anally, this is a harsh substance that wears away at the lining of the rectum and increases the possibility of seroconversion ..." Halkitis said, noting that in his research 35 percent of methamphetamine users reported this practice.

Steve Shoptaw, Ph.D., principal investigator with the Friends Research Institute in Los Angeles, said: "What we're finding is that an occasional use of methamphetamine in gay populations is a significant predictor of HIV infection, but when you move up the level of use to dependence, then methamphetamine is an outrageous predictor of infection."

At a Los Angeles substance abuse treatment center, researchers found that 62 percent of the gay and bisexual men who presented for methamphetamine treatment were HIV-positive. "The Seattle/King County Health Department in Washington ... found that 60 percent of gay IDUs who use methamphetamine were HIV-positive," Gorman said.

Methamphetamine use and its tie to HIV among MSM is a trend found outside US borders, as well. Robert Hogg, Ph.D., manager of the HIV/AIDS Drug Treatment Program at the British Columbia Center for Excellence in HIV/AIDS and principal investigator of a Vancouver study of HIV and methamphetamine use, said, "We've seen an increasing incidence of HIV in this population of MSM, and a lot of that has to do with ... a real increase in barebacking."

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